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7 Cards in this Set
- Front
- Back
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3 types of clinical presentations for pituitary tumors?
Pituitary tumors are usually what type? Classification of tumors: |
Hypersecretion (ACTH - Cushing's, GH - acromegaly, prolactinomas)
hyposecretion from compression neuro sx from mass effect - visual changes, HA, benign - 30-40% are non-secreting microadenoma - (1cm) - macroadenoma functional vs nonfunctional |
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Most common pituitary tumor:
Clinical features: Mass-effect S/S? Other causes of high prolactin? |
prolactinoma (can't screw around)
hypogonadism, amenorrhea, infertility, impotence, galactorrhea, hirsutism, acne visual loss, CN's affected, HA, CSF rhinorrhea pregnancy, primary hypothyroid, renal failure, cirrhosis, meds (TCA's, verapamil, Mdopa) |
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Lab and imaging eval for prolactinomas:
DOC for prolactinomas: |
TSH, pregnancy test, hx for meds; MRI over CT, don't use XR
bromocriptine - dopamine agonist normalizes prolactin |
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Clinical features of acromegaly:
Dx of GH excess/acromegaly: |
acral growth, large hands/feet, large jaw
excessive sweating, oily skin Carb intolerance, DM, colon polyps HTN, cardiac problems Respiratory, sleep apnea HA, goiter Elevated IGF-1 on 2 occasions, GH doesn't normalize after glucose challenge, MRI to confirm |
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Treatment for acromegaly, and which tumor type is this not recommended for?
Effectiveness of radiation therapy: analogue of somatostatin, normalizes IGF-1 levels in half of patients: |
trans-sphenoidal surgery is TOC- don't use for prolactinomas
70% octreotide, lamreotide |
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Dx lab for ACTH tumors (Cushing's):
Rarest of all pituitary tumors, rare as hen's teeth: Nonfunctioning tumors usually present with what S/S? Asymptomatic sellar masses, usually found at autopsy or looking for something else: |
24 urine cortisol
TSH tumors mass effect - visual changes, HA sellar incidentalomas |
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hemorrhage or infarct of the pituitary gland, S/S of HA, visual changes, altered mental status:
Treatment? |
pituitary apoplexy
control, neurosurgical compression |
